Rep. W. Gregory Steube

Maddy summaryHR 5912 (PUNISH Act of 2023) maintains existing U.S. sanctions against Iran by preventing the President from lifting them without new certification. It requires the State Department to submit every 180 days a report confirming Iran has not engaged in targeted violence (such as assassinations of U.S. citizens, Iranian residents in the U.S., or politically motivated abuse) over the past five years. This certification must be provided before sanctions can be waived, suspended, or reduced under current laws like the Iran Sanctions Act. The bill directly affects the President’s authority to ease sanctions, Iranian entities subject to existing sanctions, and U.S. agencies responsible for reporting. It does not create new sanctions but extends the duration of current measures until a specific certification date.

Maddy summaryThis bill, HR 5796, prohibits the Department of Health and Human Services from implementing a proposed rule requiring minimum staffing levels in nursing homes. It creates an advisory panel of 15 members - including rural nursing home staff and experts - to study workforce shortages and report on access barriers for seniors, especially in rural areas. The panel must submit an initial report within 60 days, analyzing staffing challenges and recommending solutions to strengthen the nursing home workforce. These provisions directly aim to prevent nursing home closures (like the 129 that occurred in 2022) that threaten rural seniors’ access to care.

Maddy summaryThis bill allows married couples to contribute to a single Health Savings Account (HSA) using both spouses' catch-up contribution limits. It directly affects married couples with family coverage under high-deductible health plans who are both eligible to make catch-up contributions (age 55+). The key provision changes IRS rules so that the annual HSA contribution limit is divided equally between spouses (unless they agree otherwise) and includes both spouses' catch-up amounts if they qualify. The changes apply to taxable years beginning after December 31, 2023.

Maddy summaryThis bill (HR 5608) allows health insurance issuers in the Affordable Care Act marketplaces to contribute directly to enrollees' health savings accounts (HSAs) instead of reducing cost-sharing (like deductibles) for silver-level high-deductible health plans. It affects individuals enrolled in these specific plans who elect this option, requiring insurers to pay into their HSAs monthly (equal to the cost-sharing reduction they would have received) using a medical-only debit card. Insurers must also offer high-deductible plans as alternatives to standard silver plans and provide public education about this option starting in 2025. The changes apply to months beginning after December 2024, with funds treated as advance payments toward tax credits.

Maddy summaryThis bill prevents Medicare from imposing stricter supervision requirements for outpatient physical therapy and occupational therapy than those established by state law, requiring Medicare to follow existing state regulations instead. It takes effect January 1, 2024, directly affecting Medicare-covered therapy services in all states. Additionally, it mandates a Government Accountability Office study by December 2024 to analyze how Medicare’s 15% payment differential for therapy assistants impacts access to care in rural and underserved areas. The study will examine this payment policy across all Medicare Part B settings.

Maddy summaryThe CONNECT for Health Act of 2023 aims to expand access to telehealth services under Medicare by removing barriers that previously limited who could provide these services and where they could be delivered. The bill eliminates geographic restrictions on telehealth coverage, allows telehealth services to be provided from the patient's home and other clinically appropriate locations, and expands the types of healthcare providers who can offer telehealth services. It also improves the process for adding new telehealth services to Medicare coverage and includes provisions to ensure quality measurement includes telehealth services. This legislation directly affects Medicare beneficiaries seeking remote care and healthcare providers delivering telehealth services, with key provisions taking effect between 2024 and 2025.

Maddy summaryThis bill amends Medicare rules to improve access to home infusion therapy, which delivers IV medications at home for conditions like chronic diseases. It adds pharmacy services (including drug preparation and compounding) to covered Medicare benefits and creates a payment rule: if a supplier isn't physically present during therapy, Medicare pays 50% of the full rate instead of denying payment. It also allows nurse practitioners and physician assistants to establish and review home infusion care plans, previously limited to physicians. These changes, effective January 2024, directly affect Medicare beneficiaries requiring home infusion therapy and providers delivering these services.

Maddy summaryThe Leveling the Playing Field 2.0 Act (HR 3882) updates U.S. trade law to better address international trade practices that disadvantage American businesses. It establishes special rules for handling multiple investigations of the same merchandise (called "successive investigations"), requiring the Commerce Department to consider previous injury determinations when making new findings. The bill also creates mechanisms to address market distortions from foreign government subsidies, including currency undervaluation, and strengthens procedures to prevent duty evasion through certification requirements for importers. These changes primarily affect foreign exporters of goods subject to U.S. antidumping and countervailing duty investigations, as well as U.S. importers of those goods.

Maddy summaryThis bill establishes "cottage family homes" as a new foster care placement option under federal law. It defines cottage homes as licensed residences caring for up to 2 children per bedroom (with exceptions), requiring trauma-informed care, prohibiting most restraints, and mandating systems for children to report concerns. The bill directly affects foster children placed in these homes and state child welfare agencies, by making cottage homes eligible for federal foster care maintenance payments without time limits. Key provisions include requiring states to adopt the new definition, allowing states flexibility in how they classify these homes, and ensuring children in cottage homes receive the same care standards as those in traditional foster placements.

Maddy summaryThis bill requires Medicare to collect detailed cost data from air ambulance providers every three years, including operating costs per base, revenue, and service utilization. It also directs the Government Accountability Office (GAO) to study air ambulance costs, Medicare payment adequacy, geographic variations, and payor mix. The goal is to inform future adjustments to Medicare's payment rates for these services. This directly affects Medicare beneficiaries using air ambulance services and the providers operating them.